Responding to Students in Distress

Introduction

As a UWG staff or faculty member, you are in an excellent position to recognize
behavioral changes that characterize the emotionally troubled student. A student's
behavior, especially if it is inconsistent with your previous observations could
well constitute an inarticulate attempt to draw attention to his or her plight,
(i.e., a "cry for help"). Your ability to recognize the signs of emotional
distress, and the courage to acknowledge your concerns directly to the student,
are often noted by students as the most significant factor in their successful
resolution of their problems.

Your Response

Involve yourself only as far as you are willing to go. At times, in an attempt
to reach or help a troubled student, you may become more involved than time
or skill permits. It is important to know the boundaries and limitations of
your intervention. If you decide to take action, you should follow these guidelines
when approaching a distressed student:

Request to see the student in private. This may help minimize embarrassment
and defensiveness. If you feel imminent danger, interview with a partner.

Openly acknowledge to the student you are aware of their distress.

Speak directly and honestly and acknowledge you are sincerely concerned
about their welfare and you are willing to help them explore their alternatives.

Strange or inappropriate behavior should not be ignored. Question directly,
but be sensitive about what you have observed. Be careful not to provoke aggressive
behavior.

Listen carefully to what the student is troubled about and try to see the
issue from his/her point of view without necessarily agreeing or disagreeing.

Attempt to succinctly identify the student's problem or concern and explore
alternatives to deal with the problem.

Refer the student to professional help when appropriate.

Inform the Student Development Center

If you determine suicidal risk is present, do not leave the student alone
until physically with Student Development, University Police, or Health Services.

Supporting different types of students:

The Anxious Student

For these types of students, danger is everywhere, even though what makes
students anxious is often unknown. Not knowing what is expected and conflict
are primary causes of anxiety. Unknown and unfamiliar situations raise their
anxiety; high and unreasonable self-expectations increase anxiety also. These
students often have trouble making decisions.

Do:

let them discuss their feelings and thoughts - this alone often relieves
a great deal of pressure.

reassure when appropriate.

remain calm.

be clear and explicit.

offer referral to the Student Development Center for counseling and biofeedback
training.

Don't:

make things more complicated.

take responsibility for their emotional state.

overwhelm with information or ideas.

The Depressed Student

Typically, these students get the most sympathy. They show a multitude of
symptoms,
e.g., guilt, low self-esteem, feelings of worthlessness, and inadequacy as
well as physical symptoms such as decreased or increased appetite, difficulty
staying asleep, early awakening, low interest in daily activities. They usually
show low activity levels because everything is an effort and they have little
energy.

Do:

let student know you're aware he/she is feeling down and you would like
to help.

reach out more than halfway and encourage the student to express how she/he
is feeling, for he/she is often initially reluctant to talk, yet others' attention
helps the student feel more worthwhile.

tell student of your concern.

Offer referral to the Student Development Center (678-839-6428) or Health
Services (678-839-6452).

be afraid to ask whether the student is suicidal if you think he/she may
be.

The Student in poor contact with reality

These students have difficulty distinguishing fantasy from reality, the dream
from the waking state. Their thinking is typically illogical, confused, disturbed;
they may coin new words, see or hear things which no one else can, have irrational
beliefs, and exhibit bizarre or inappropriate behavior. Generally, these students
are not dangerous and are very scared, frightened and overwhelmed. However,
they can become dangerous if provoked by argument or debate.

Do:

respond with warmth and kindness, but with firm reasoning and attempt to
not show fear or shock.

remove extra stimulation of the environment and see them in a quiet atmosphere
(if you are comfortable in doing so).

acknowledge your concerns and state that you can see they need help, (e.g., "It
seems very hard for you to integrate all these things that are happening and
I am concerned about you. I'd like to help.")

acknowledge the feelings or fears without supporting the misperceptions,
(e.g., "I understand you think they are trying to hurt you and I know
how real it seems to you, but I don't hear the voices (see the devil, etc.).") This
should be done in a sensitive rather than argumentative manner.

reveal your difficulty in understanding them (when appropriate), (e.g., "I'm
sorry but I don't understand. Could you repeat that or say it in a different
way?")

focus on the "here and now." Switch topics and divert the focus
from the irrational to the rational or the real.

speak to their healthy side, which they DO have. It's O.K. to joke, laugh,
or smile when appropriate. Remind them they are stronger than their irrational
thoughts (e.g.voices or images).

Refer them to Student Development (678-839-6428) or Health Services (678-839-6452).
If after hours, call University Police (678-839-6000).

Don't:

argue or try to convince them of the irrationality of their thinking for
it makes them defend their positions (false perceptions) more.

"play along", (e.g., "Oh yeah, I hear the voices (or see
the devil).")

encourage further revelations of craziness.

demand, command, or order.

expect customary emotional responses.

attempt to hug, restrain or touch the patient without the student’s
express permission.

The Suicidal Student

Suicide is the second leading cause of death among college students. UWG
advocates a team approach involving trained professionals. Suicide attempts
or serious contemplation should always be addressed by trained professionals.
Always refer. Most people who contemplate suicide are ambivalent about killing
themselves and typically respond to help. Suicidal students usually attempt
to communicate their feelings prior to attempting suicide.

High risk indicators include:

Talking about death

A detailed suicidal plan

History of a previous attempt

Giving away personal possessions

A severe loss or threat of loss

History of alcohol or drug abuse (especially new onset or increased use)

Feelings of hopelessness, helplessness, and futility

Feelings of alienation and isolation

Do:

Always report conversations about suicide to professionals at the Student
Development Center or Health Services (DO NOT agree to keep it a secret)

Take the student seriously - 80% of suicides give warning of their intent.

Reassure the student that there are always options and help available

Acknowledge that a threat of or attempt at suicide is a plea for help. Thoughts
about suicide do not constitute a threat.

Be available to listen, to talk, to be concerned, and contact a professional
team member as soon as possible. Contact University Police (678-839-6000)
or Student Development (678-839-6428).
They can get you immediate help while you remain with resident (as long
as it is safe for you to do so)

Take care of yourself. Helping someone who is suicidal is hard, demanding,
and draining work. Talk to a counselor after your experience.

Don't:

Try to physically struggle with or attempt to disarm a student.

Minimize the situation or depth of feeling, e.g. "Oh it will be much
better tomorrow” or “You don’t really mean that…."

Over commit yourself and, therefore, not be able to deliver on what you
promise

Respond beyond your training; always refer.

leave the student alone if concerned there is substantial or imminent risk.

Confronting a Student

Confronting a student does not require judging, blaming, or attacking the
person. It does not require demeaning or forcing the person to take action.
Confronting someone means that you have the courage to let the student know
what you have seen and heard, that you are concerned about them and that you
are willing to help. Listed below are some practical tips on confronting a resident,
a friend, or anyone else you care about.

Be HONEST and SPECIFIC:
Explain why you want to have a serious talk and what you hope will happen
(and what you hope doesn't happen).
Example:" I am really worried about your drinking and I hope you won't
just blow me off or think I am just putting you down...I don't want to wreck
our friendship..."

Describe your OBSERVATIONS:
Describe your non-judgmental observations if the student’s behavior in
a way that expresses concern.
Example: "I am concerned that since last Friday night you have come back
to our room really drunk four times, twice you said you drove home drunk and
last night you threw-up all over our floor...".

Express your FEELINGS:
Example: "I am really worried about you...I am scared to talk to you in
a serious way because I think you don't realize you have a problem...and bringing
it up might just piss you off..."

Offer your RECOMMENDATIONS:
Example: "I really wish you would go talk to someone about your [specific
behavior]...see if you do have a problem. You could either talk with a physician
at Health Services (6787-839-6452) or a counselor at the Student Development
Center (678-839-6428)... whoever you would be most comfortable with...I'll go
with you... The services are free and they are on campus."

LISTEN actively to what your resident says:
Listening "actively" does not require that you necessarily agree or
disagree with your friend. The important part is that you accurately hear what
your friend is saying so he or she feels heard and understood. One way to communicate
that you are listening and understand is to paraphrase what your friend says,
from their point of view, and to then to restate your observations and recommendations.

Always call for help:

Never put yourself in an unsafe position. Always get help. Your supervisor
is your first line of assistance and support. ALWAYS share your concerns
about students with your supervisor. ALWAYS work with your supervisor when you need
support for yourself. In addition, consult with the Student Development Center
for a counselor, who can speak with the student.